The Killer Rise of Fentanyl

In cities across America, the synthetic opioid fentanyl has created a public health crisis of unprecedented magnitude. The drug, mostly unknown just a few years ago, has led to record-setting overdose deaths and appears to be the new and deadly face of the opioid epidemic.

Because of its strength—some 50 times more powerful than heroin—it can overwhelm even experienced drug users, leading to overdose. In certain markets, the mixture of synthetic drugs like fentanyl added to heroin changes frequently, further increasing the risk to users. Notably, the drug is so potent that even antidotes like Naloxone (Narcan) can’t save users who have taken a strong enough dose. Fentanyl has led to a staggering rise in fatalities nationwide, a trend that is particularly visible in the country’s urban areas.

In 24 of the nation’s largest cities and the counties that surround them, fentanyl-related overdose deaths increased by nearly 600 percent from 2014 to 2016, according to county health departments nationwide. By way of example, Cook County, Illinois (Chicago) saw a 2,700 percent increase in fentanyl fatalities in a 2 year period. The Philadelphia area has been hardest hit jumping from 100 overdose deaths in 2014, to 2000 in 2016—marking the first time in recent state history that heroin was not the most deadly overdose drug. The numbers continue to rise, and fentanyl was involved in some 60 percent of opioid deaths in 2017, according to the National Center on Health Statistics.

Cheap, Easy and Available

Fentanyl was created in 1960 as a treatment for cancer pain and has taken over the black market because it’s cheap, easy to make and easy to transport. There’s no need to grow and protect acres of poppies; fentanyl can be cooked up in a lab. And because it is so potent — a few granules pack a deadly punch — it can be mailed around the world in small, difficult to detect packages. Drug labs in China take online orders from American users, or from traffickers elsewhere in North America who add the fentanyl to heroin and other drugs to bolster their effect, or press it into fake prescription opioid pills.

Fentanyl is in fact so deadly, that even incidental contact with it can lead to overdose. Health care workers and law enforcement officers are taking unprecedented new precautions to avoid unintentional contact with the drug. Medical examiners, who investigate causes of death, have adopted new protective measures like nitrile gloves and Tyvek suits in autopsy rooms and morgues, because dead bodies could contain traces of the drug. A police officer in East Liverpool, Ohio, accidentally overdosed in May after a traffic stop when he used his hand to brush powdered fentanyl off his uniform.

Roots of the Crisis

The origins of the opioid epidemic can be traced to the mid-nineties, when pharmaceutical companies began producing new synthetic opioids, such as Oxycontin, that were considered safer and less addictive than previously available drugs. Simultaneously, the collective thinking of the medical establishment shifted towards the notion that being free from pain was a basic human right. Doctors began to treat pain more liberally and prescribed these new medications for a huge range of conditions. As demand grew, the price of prescription opioids rose. Patients who had become unwittingly addicted turned to a cheaper option: heroin.

Eventually, as people developed a tolerance to heroin and prescription pills, dealers and users alike sought out options that were cheaper and stronger. Enter Fentanyl.

Although many people specifically seek out fentanyl because of it’s potency, there are many more who overdose on the drug unwittingly after it is cut into other drugs—heroin, most frequently, but also cocaine and pills.

This migration of fentanyl into other drug supplies has led to the nightmarish recent overdose stats—as relatively naïve drug users and experienced users alike are caught unaware by the drug’s fatal punch.

Carfentanil

What’s worse, newer, even more, deadly drugs are hitting the market. Enter carfentanil. The drug was originally used as an elephant tranquilizer and is an estimated 100 times even more potent than fentanyl. Certain areas are now seeing more overdoses involving this potent killer.